A patient who has been taking 10 mg per day of prednisone for the past six months should be assessed for:
A Gout
B Iron deficiency anemia
C Osteoporosis
D Renal dysfunction
The correct answer and explanation is:
The correct answer is C. Osteoporosis.
Explanation:
Prednisone is a corticosteroid medication commonly prescribed to treat conditions like autoimmune diseases, inflammation, and allergies. Long-term use of prednisone, especially in doses like 10 mg per day for six months, can lead to a range of side effects. One of the most significant risks is the development of osteoporosis, a condition characterized by weakened bones that are more susceptible to fractures.
Corticosteroids like prednisone interfere with the body’s ability to maintain a healthy bone density. They do this by decreasing calcium absorption from the gut, reducing the amount of calcium in the bones, and promoting the breakdown of bone tissue by osteoclasts (cells that resorb bone). Over time, this imbalance between bone resorption and bone formation leads to bone loss, making bones fragile and increasing the risk of fractures, particularly in weight-bearing bones like the spine, hips, and wrists.
Patients who have been on long-term corticosteroid therapy should be regularly monitored for signs of osteoporosis. This might include measuring bone mineral density (BMD) through a DEXA scan (dual-energy x-ray absorptiometry) to assess bone strength. Additionally, patients may be prescribed medications like bisphosphonates or calcium and vitamin D supplements to help mitigate bone loss.
While gout, iron deficiency anemia, and renal dysfunction can also be seen in patients on corticosteroids, they are not as directly linked to long-term prednisone use as osteoporosis. Gout could occur due to prednisone’s effects on purine metabolism, iron deficiency anemia may be linked to other factors, and renal dysfunction is typically more associated with high doses or prolonged therapy involving other medications. Thus, osteoporosis remains the most pertinent concern for a patient who has been on low-dose prednisone for an extended period.